QUALITY IMPROVEMENT PROJECT ON SAFE MEDICATION PRACTICES

Leena Chandrasekaran1, Pushpalatha Murugesh2, Baby Lakshmi Saman Padavettan3

INTRODUCTION- Patient safety is a common goal for every healthcare provider. Of which, Medication safety is one of the topmost priority. Medication errors are preventable errors that occur in Hospitals which may lead to severe harm, disability, and even death. Nurses who play a pivotal role in Medication administration must follow safe medication administration practices in every possible situation. Hence, to prevent & reduce the occurrence of medication errors, we have Initiated a Medication administration Quality Improvement Project at our hospital.

AIM- 1. To assess the existing practices related to medication administration and documentation, 2. To implement best practices in prescribing, transcribing, dispensing, administration, and documentation of medication.3. To reassess medication administration and documentation practices after implementing best practices

METHOD- Descriptive study design, wards and ICUs of Mehta Multispeciality Hospitals was the setting. A convenient sampling technique was used to select the samples and a sample size of 160 nurses in 2 audit cycles and 219 nurses. The first audit was done before implementing best practices and the other 2 audits were done after implementation of medication prescription, transcription, dispensing, administration, and documentation best practices. Those who got a score of 75-100% were categorized as those who had adequate practice, 50- 74% scores were categorized as those who had moderately adequate practice, and those with less than 50% scores were categorized as those with inadequate medication administration and documentation-related practices.

RESULTS- The medication administration and documentation practices markedly improved from 63.7% to 93.5%. Medication administration errors and documentation error incidence had dropped from 50 to 19 and 11 to 7 respectively.

CONCLUSIONS- Our initial audit helped us to Identify potential and actual medication errors at different stages, these findings gave us an urge to learn and implement best practices starting from medication prescription to medication documentation. These ongoing audits and best practices, Introduction enabled the reduction of preventable medication errors. We were able to see improved practices at the bedside (63% – 93% ). We also observed that the overall Incidence of medication Errors had reduced as per Set Benchmarks. Double check / HIS Alerts /Top-down Proactive Approach – has become a Culture of the Nursing team.

The Introduction of HIS controls, CPOE, Drug presentations, Incidental teaching, Labels, Colour coding ( LASA and HR drugs)  Reinforcement sessions, and clinical supervision by senior Nurse leaders played a major role in Ensuring drug safety and thus helped in Safe Medication administration practices which ultimately reduced our Incidences of Medication Errors